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Published in: Knee Surgery, Sports Traumatology, Arthroscopy 8/2018

01-08-2018 | Knee

Discoid lateral meniscus can be overlooked by magnetic resonance imaging in patients with meniscal tears

Authors: Dong-Wook Sohn, Seong-Il Bin, Jong-Min Kim, Bum-Sik Lee, Seon-Jeong Kim

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 8/2018

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Abstract

Purpose

MRI evaluation of torn lateral meniscus was compared with arthroscopy. This study calculates the sensitivity, specificity, and accuracy of MRI in determining the presence or absence of discoid lateral meniscus (DLM) for different tear types.

Methods

MR imaging of 156 knees with arthroscopically confirmed lateral meniscus tears was analysed. There were 78 knees (70 patients) in non-DLM group and 78 knees (74 patients) in DLM group on arthroscopy as the reference standard. The presence of DLM on MRI was determined by an orthopaedic surgeon and a radiologist, who were blinded to the arthroscopic findings. The presence of discoid meniscus on MRI was determined by coronal and sagittal measurements, considering the tear pattern of lateral meniscus. The tear pattern was categorized into six types based on arthroscopic findings: horizontal, longitudinal, radial, combined radial, degenerative, and complex tear. The sensitivity, specificity, and accuracy of MRI were calculated for each type of lateral meniscus tear. In addition, we analysed the reason for non-detection of discoid meniscus on preoperative MRI.

Result

The sensitivity for determining the presence of discoid meniscus was 58% for radial tear, 57% for combined radial tear, and 65% for longitudinal tear, whereas the specificity was 100% for all tear groups. In the presence of radial or longitudinal tear, the accuracy of MRI was significantly lower than having no radial and longitudinal tear (p < 0.001). The presence of discoid meniscus was not recognized on MRI because of large radial tear (12 knees), deformed bucket-handle tear (6 knees), and inverted flap tear (3 knees).

Conclusions

MRI was not successful in determining the presence or absence of DLM in radial tear, combined radial tear, and longitudinal tear. When there are large radial tear, deformed bucket-handle tear, and inverted flap tear in lateral meniscus, it is recommended to consider the possibility of DLM. This information can help to make accurate diagnosis of DLM, which allows appropriate surgical planning and facilitates patient’s information on poor prognosis of DLM.

Level of evidence

Level I.
Literature
1.
go back to reference Adachi N, Ochi M, Uchio Y, Kuriwaka M, Shinomiya R (2004) Torn discoid lateral meniscus treated using partial central meniscectomy and suture of the peripheral tear. Arthroscopy 20:536–542CrossRefPubMed Adachi N, Ochi M, Uchio Y, Kuriwaka M, Shinomiya R (2004) Torn discoid lateral meniscus treated using partial central meniscectomy and suture of the peripheral tear. Arthroscopy 20:536–542CrossRefPubMed
2.
go back to reference Ahn JH, Choi SH, Lee YS, Yoo JC, Chang MJ, Bae S, Bae YR (2011) Symptomatic torn discoid lateral meniscus in adults. Knee Surg Sports Traumatol Arthrosc 19:158–164CrossRefPubMed Ahn JH, Choi SH, Lee YS, Yoo JC, Chang MJ, Bae S, Bae YR (2011) Symptomatic torn discoid lateral meniscus in adults. Knee Surg Sports Traumatol Arthrosc 19:158–164CrossRefPubMed
3.
go back to reference Ahn JH, Kim KI, Wang JH, Jeon JW, Cho YC, Lee SH (2015) Long-term results of arthroscopic reshaping for symptomatic discoid lateral meniscus in children. Arthroscopy 31:867–873CrossRefPubMed Ahn JH, Kim KI, Wang JH, Jeon JW, Cho YC, Lee SH (2015) Long-term results of arthroscopic reshaping for symptomatic discoid lateral meniscus in children. Arthroscopy 31:867–873CrossRefPubMed
4.
go back to reference Ahn JH, Lee SH, Yoo JC, Lee YS, Ha HC (2008) Arthroscopic partial meniscectomy with repair of the peripheral tear for symptomatic discoid lateral meniscus in children: results of minimum 2 years of follow-up. Arthroscopy 24:888–898CrossRefPubMed Ahn JH, Lee SH, Yoo JC, Lee YS, Ha HC (2008) Arthroscopic partial meniscectomy with repair of the peripheral tear for symptomatic discoid lateral meniscus in children: results of minimum 2 years of follow-up. Arthroscopy 24:888–898CrossRefPubMed
5.
go back to reference Araki Y, Yamamoto H, Nakamura H, Tsukaguchi I (1994) MR diagnosis of discoid lateral menisci of the knee. Eur J Radiol 18:92–95CrossRefPubMed Araki Y, Yamamoto H, Nakamura H, Tsukaguchi I (1994) MR diagnosis of discoid lateral menisci of the knee. Eur J Radiol 18:92–95CrossRefPubMed
6.
go back to reference Atay OA, Pekmezci M, Doral MN, Sargon MF, Ayvaz M, Johnson DL (2007) Discoid meniscus: an ultrastructural study with transmission electron microscopy. Am J Sports Med 35:475–478CrossRefPubMed Atay OA, Pekmezci M, Doral MN, Sargon MF, Ayvaz M, Johnson DL (2007) Discoid meniscus: an ultrastructural study with transmission electron microscopy. Am J Sports Med 35:475–478CrossRefPubMed
7.
go back to reference Bin SI, Kim JC, Kim JM, Park SS, Han YK (2002) Correlation between type of discoid lateral menisci and tear pattern. Knee Surg Sports Traumatol Arthrosc 10:218–222CrossRefPubMed Bin SI, Kim JC, Kim JM, Park SS, Han YK (2002) Correlation between type of discoid lateral menisci and tear pattern. Knee Surg Sports Traumatol Arthrosc 10:218–222CrossRefPubMed
8.
go back to reference Choi NH, Yang BS, Lee SY, Lee CC, Lee CY, Victoroff BN (2017) Comparison of the insertion of the posterior horn of the lateral meniscus: discoid versus non-discoid. Knee Surg Sports Traumatol Arthrosc 25:397–402CrossRefPubMed Choi NH, Yang BS, Lee SY, Lee CC, Lee CY, Victoroff BN (2017) Comparison of the insertion of the posterior horn of the lateral meniscus: discoid versus non-discoid. Knee Surg Sports Traumatol Arthrosc 25:397–402CrossRefPubMed
9.
go back to reference Dandy DJ (1990) The arthroscopic anatomy of symptomatic meniscal lesions. J Bone Joint Surg Br 72:628–633CrossRefPubMed Dandy DJ (1990) The arthroscopic anatomy of symptomatic meniscal lesions. J Bone Joint Surg Br 72:628–633CrossRefPubMed
10.
go back to reference Fleissner PR, Eilert RE (1999) Discoid lateral meniscus. Am J Knee Surg 12:125–131PubMed Fleissner PR, Eilert RE (1999) Discoid lateral meniscus. Am J Knee Surg 12:125–131PubMed
11.
go back to reference Good CR, Green DW, Griffith MH, Valen AW, Widmann RF, Rodeo SA (2007) Arthroscopic treatment of symptomatic discoid meniscus in children: classification, technique, and results. Arthroscopy 23:157–163CrossRefPubMed Good CR, Green DW, Griffith MH, Valen AW, Widmann RF, Rodeo SA (2007) Arthroscopic treatment of symptomatic discoid meniscus in children: classification, technique, and results. Arthroscopy 23:157–163CrossRefPubMed
12.
13.
go back to reference Kim YG, Ihn JC, Park SK, Kyung HS (2006) An arthroscopic analysis of lateral meniscal variants and a comparison with MRI findings. Knee Surg Sports Traumatol Arthrosc 14:20–26CrossRefPubMed Kim YG, Ihn JC, Park SK, Kyung HS (2006) An arthroscopic analysis of lateral meniscal variants and a comparison with MRI findings. Knee Surg Sports Traumatol Arthrosc 14:20–26CrossRefPubMed
14.
go back to reference Klingele KE, Kocher MS, Hresko MT, Gerbino P, Micheli LJ (2004) Discoid lateral meniscus: prevalence of peripheral rim instability. J Pediatr Orthop 24:79–82CrossRefPubMed Klingele KE, Kocher MS, Hresko MT, Gerbino P, Micheli LJ (2004) Discoid lateral meniscus: prevalence of peripheral rim instability. J Pediatr Orthop 24:79–82CrossRefPubMed
15.
go back to reference Kramer DE, Micheli LJ (2009) Meniscal tears and discoid meniscus in children: diagnosis and treatment. J Am Acad Orthop Surg 17:698–707CrossRefPubMed Kramer DE, Micheli LJ (2009) Meniscal tears and discoid meniscus in children: diagnosis and treatment. J Am Acad Orthop Surg 17:698–707CrossRefPubMed
16.
go back to reference Kwon SK, Moon HK, Choi CJ, Park SH, Lee JJ, Kim YC, Park YS, Koh YG (2015) Accelerated degeneration of the discoid lateral meniscus after medial opening wedge high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc 23:97–103CrossRefPubMed Kwon SK, Moon HK, Choi CJ, Park SH, Lee JJ, Kim YC, Park YS, Koh YG (2015) Accelerated degeneration of the discoid lateral meniscus after medial opening wedge high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc 23:97–103CrossRefPubMed
17.
go back to reference LaMont L, Ellis H, Wise K, Wilson P (2016) The inverted discoid meniscus segment: clinical, radiographic, and arthroscopic description of a hidden tear pattern. Am J Sports Med 44:1534–1539CrossRefPubMed LaMont L, Ellis H, Wise K, Wilson P (2016) The inverted discoid meniscus segment: clinical, radiographic, and arthroscopic description of a hidden tear pattern. Am J Sports Med 44:1534–1539CrossRefPubMed
18.
go back to reference Lee CR, Bin SI, Kim JM, Kim NK (2016) Magnetic resonance imaging findings in symptomatic patients after arthroscopic partial meniscectomy for torn discoid lateral meniscus. Arthroscopy 32:2366–2372CrossRefPubMed Lee CR, Bin SI, Kim JM, Kim NK (2016) Magnetic resonance imaging findings in symptomatic patients after arthroscopic partial meniscectomy for torn discoid lateral meniscus. Arthroscopy 32:2366–2372CrossRefPubMed
19.
go back to reference Lee DH, Kim TH, Kim JM, Bin SI (2009) Results of subtotal/total or partial meniscectomy for discoid lateral meniscus in children. Arthroscopy 25:496–503CrossRefPubMed Lee DH, Kim TH, Kim JM, Bin SI (2009) Results of subtotal/total or partial meniscectomy for discoid lateral meniscus in children. Arthroscopy 25:496–503CrossRefPubMed
20.
go back to reference Liu C, Zheng HY, Huang Y, Li HP, Wu H, Sun TS, Yao JH (2016) Double PCL sign does not always indicate a bucket-handle tear of medial meniscus. Knee Surg Sports Traumatol Arthrosc 24:2806–2810CrossRefPubMed Liu C, Zheng HY, Huang Y, Li HP, Wu H, Sun TS, Yao JH (2016) Double PCL sign does not always indicate a bucket-handle tear of medial meniscus. Knee Surg Sports Traumatol Arthrosc 24:2806–2810CrossRefPubMed
21.
go back to reference Matsuo T, Kinugasa K, Sakata K, Ohori T, Mae T, Hamada M (2017) Post-operative deformation and extrusion of the discoid lateral meniscus following a partial meniscectomy with repair. Knee Surg Sports Traumatol Arthrosc 25:390–396CrossRefPubMed Matsuo T, Kinugasa K, Sakata K, Ohori T, Mae T, Hamada M (2017) Post-operative deformation and extrusion of the discoid lateral meniscus following a partial meniscectomy with repair. Knee Surg Sports Traumatol Arthrosc 25:390–396CrossRefPubMed
22.
go back to reference Papadopoulos A, Kirkos JM, Kapetanos GA (2009) Histomorphologic study of discoid meniscus. Arthroscopy 25:262–268CrossRefPubMed Papadopoulos A, Kirkos JM, Kapetanos GA (2009) Histomorphologic study of discoid meniscus. Arthroscopy 25:262–268CrossRefPubMed
23.
go back to reference Ryu KN, Kim IS, Kim EJ, Ahn JW, Bae DK, Sartoris DJ, Resnick D (1998) MR imaging of tears of discoid lateral menisci. AJR Am J Roentgenol 171:963–967CrossRefPubMed Ryu KN, Kim IS, Kim EJ, Ahn JW, Bae DK, Sartoris DJ, Resnick D (1998) MR imaging of tears of discoid lateral menisci. AJR Am J Roentgenol 171:963–967CrossRefPubMed
24.
go back to reference Samoto N, Kozuma M, Tokuhisa T, Kobayashi K (2002) Diagnosis of discoid lateral meniscus of the knee on MR imaging. Magn Reson Imaging 20:59–64CrossRefPubMed Samoto N, Kozuma M, Tokuhisa T, Kobayashi K (2002) Diagnosis of discoid lateral meniscus of the knee on MR imaging. Magn Reson Imaging 20:59–64CrossRefPubMed
25.
go back to reference Silverman JM, Mink JH, Deutsch AL (1989) Discoid menisci of the knee: MR imaging appearance. Radiology 173:351–354CrossRefPubMed Silverman JM, Mink JH, Deutsch AL (1989) Discoid menisci of the knee: MR imaging appearance. Radiology 173:351–354CrossRefPubMed
27.
go back to reference Yilgor C, Atay OA, Ergen B, Doral MN (2014) Comparison of magnetic resonance imaging findings with arthroscopic findings in discoid meniscus. Knee Surg Sports Traumatol Arthrosc 22:268–273CrossRefPubMed Yilgor C, Atay OA, Ergen B, Doral MN (2014) Comparison of magnetic resonance imaging findings with arthroscopic findings in discoid meniscus. Knee Surg Sports Traumatol Arthrosc 22:268–273CrossRefPubMed
Metadata
Title
Discoid lateral meniscus can be overlooked by magnetic resonance imaging in patients with meniscal tears
Authors
Dong-Wook Sohn
Seong-Il Bin
Jong-Min Kim
Bum-Sik Lee
Seon-Jeong Kim
Publication date
01-08-2018
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 8/2018
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-017-4704-6

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